Hailen Matthew Ackerman

Individual provider Active NPI Behavior Technician · Fargo, ND

NPI 1154922201 · NPPES record last updated Nov 5, 2020

Key facts

NPI
1154922201
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4725 Amber Valley Pkwy S Ste B
Fargo, ND 58104-8614
Phone
(701) 478-0221
NPI assigned
Nov 5, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

4725 Amber Valley Pkwy S Ste B
Fargo, ND 58104-8614

Mailing address

4725 Amber Valley Pkwy S Ste B
Fargo, ND 58104-8614

Other providers in Fargo, ND

All providers in Fargo, ND · Behavior Technician in North Dakota

Sources for this page

Verify at the official NPI Registry.